”Never name that disease …… that disease is a sleeping devil, wake up loudly and it storms out.” Bi Shumin, who used to be a doctor, describes breast cancer in this way in her novel “Save the Breast”. A few months ago, Yu Juan, a 33-year-old female teacher at Fudan, left the world she loved so much due to advanced breast cancer, leaving behind a diary of her fight against cancer with tears and laughter on her blog, as well as the fragrant death of Sister Lin and the sudden death of singer Ah Sang, all of which sparked people’s concern about breast cancer. The breast, a symbol of sexuality and charm given to women by God, also unkindly lurks a demon. In the United States, one in eight women may be haunted by this demon in their lifetime, and the incidence of breast cancer in China has jumped to the first place of female tumors in big cities. Saving the breast is not just a slogan. But we are faced with such a problem. Imagine this scenario, one day a healthy white woman in her early 40s with good looks comes into the office and tells the doctor that she wants to be screened for breast cancer and that her best friend recently passed away from advanced breast cancer. Although this friend had maintained the healthiest lifestyle possible, she still had a hard time escaping the disease, which caused her to panic. This woman had no breast discomfort, had her first period at 14, had her first child at 26, was slightly overweight, drank two glasses of wine a night, and did not have any family history of breast or ovarian cancer. What advice should her doctor give to save her breasts? In other words, which women should we screen for mammogram breast cancer and how often should we do it, every 1 year or every 2 years? This is the most common problem in medical decision making – the ratio of benefit-to-cost – no test is 100% accurate and no treatment is guaranteed to cure the disease. Before making a decision, doctors always go through some careful and scientific thinking: whether the benefits of this decision outweigh the disadvantages and whether it is worth trying. Doctors went through the same decision-making process when considering whether to give this woman routine mammography screening – the benefits in terms of reducing breast cancer mortality and improving survival time, and the costs in terms of the high sensitivity of the test leading to a high false-positive rate, which can lead to unnecessary over-diagnosis and over-screening. After a large population survey and meta-analysis, this trade-off was found to be related to the age of the women [Note]. It is now generally recognized internationally that mammography screening for women in the 50-69 age group is scientifically sound and can significantly reduce breast cancer mortality in women in this age group, with a 14% decline in the 50-59 age group and 32% in the 60-69 age group. This has been confirmed by numerous studies due to the higher incidence of breast cancer in women at this age (about 2.26-3.94 per 1000 per year) and the lower breast density, which gives satisfactory sensitivity and specificity for mammography. For older women (70 years and older), there is a lack of sufficiently compelling data to support that mammography screening does more good than harm in reducing breast cancer mortality, and models based on available data estimate that screening would be required to reduce the number of women aged 70-74 years who die from breast cancer by two, and this benefit is wiped out for those older than 74 years. Also breast cancer screening does not apply to women with severe underlying disease or a life expectancy of less than the next 5-10 years.